In India, pulmonary tuberculosis accounts for 85 percent of cases and extrapulmonary tuberculosis accounts for 15 percent of cases with bone and joint involvement seen in 1 to 3 percent cases. ‘Primary tubercular osteomyelitis’ of sternum is a rare form of extrapulmonary tuberculosis in which tuberculosis is primarily affecting the sternum. It is very rare form of presentation even in the developing countries, where tuberculosis is endemic, with only few cases reported in the literature. Tuberculous sternal involvement is seen in approximately 1% of all skeletal TB cases and approximately 0.3% of all types of osteomyelitis. We report an unusual case of primary manubrio-sternal joint tuberculosis presenting as vague anterior chest wall swelling and pain.
A 45-year-old man presented with 9 months’ history of pain over the center of the anterior aspect of upper chest wall. Pain was insidious in onset. It was localized and used to subside by taking analgesics. It was aggravated by physical activity and coughing. A history of loss of appetite and weight was present.